Experts, committees and awareness groups will rally this Tuesday (4/2/13) for Autism Awareness Day. They will speak of the continued efforts to develop and expand the current philosophies and research about why autism rates have exploded in the last few decades.

While each day and each hour passes, the sense of urgency is carved deeper into all of our lives, young and old.

….leaving us grasping for anything that can be done.

ASD is an extremely heterogeneous group of disorders with multiple subgroups that share a behavioral commonality. There is no medical or genetic test for autism and there is no one underlying cause of ASD – to some extent prevention is elusive. However, there are certain risk factors that are associated with an increase of susceptibility of ASD. [*]

We know that environmental toxicity and nutrition can play a key role in mythylation (a process the controls how genes are expressed). We must begin to use the knowledge we have gathered about known factors contributing to autism and apply them to our lives!

Environment

It is known that ‘environmental exposures and genetic susceptibility work in concert’ to increase the risk of ASD and becoming aware of environment stressors and exposures can play a pivotal role in the prevention ASD.[*][*][*][*][*]

When it comes to pesticides, our knowledge base is still growing about the timing, dose and which of the various mechanisms induce ASD. But what we do know, beyond any hesitation, is that pesticide exposure can impair neurodevelopment in children.[*][*][*][*]

Eat Organic (or local) Food

Wheat and corn products are the two most likely commodities contributing to pesticide exposure in children. Organic does make a difference.[*][*]

If the increased cost of more natural options deters you from eliminating chemical-laden cleaners and products, try making them yourself! There are many options available now and the competition among natural products have driven consumer prices down in recent years.

Be cautious of Flame Retardant chemicals (FR, PBDE)

In 2012, research was published that confirmed that flame retardant chemicals affected a specific gene mutation linked to Rett’s syndrome (a condition on the autism spectrum that primarily affects girls).[*]

This particular point can be challenging since products aren’t required to be labeled as containing these chemicals. Becoming more aware of which products contain FR is the first step.

You can cover mattresses and pillows with allergen barriers to reduce exposure to dust that contains PBDEs (I place a polyethylene shower curtain on our mattresses). You can also use a vacuum fitted with a HEPA filter or an air cleaner with a HEPA filter which reduces the FR-contaminates in the house. You can read more here as well.

If dry cleaning your clothes, find a ‘green’ dry cleaner.

Most dry cleaning facilities will use a chemical called perchlorethylene, this is a known carcinogen and exposure has been associated with male animal models developing autism-like symptoms.[*]

Filter your water

Most of us are lucky enough to have access to treated water, however the water that comes out of the tap isn’t just H2O. Thanks to contamination from agriculture chemicals, cleaning products, pesticides, fertilizers, runoff from waste disposal sites, and industrial dumping – over 200 synthetic chemicals can be found in our drinking water. [*]

Lead is a heavy metal known to affect brain and nervous function – especially dangerous in children. Fluoride in water also influences hormones and brain function. Learn more about your filter choices at the Natural Resource Defense Council’s website here.[*][*][*][*]

‘Green’ industrial cleaners at school (daycares) too

Petition your local school to use cleaners that are safe for children. Using heavy-duty industrial cleaners increase indoor air pollution. Children are, of course, more vulnerable to the fumes inhaled by harsh chemical products (children breathe more air per pound of body weight than adults). Also, the residue from the chemicals used are absorbed through the skin and absorbed into the body.

When you think of air pollution, you are not likely to think about the pollution in your house – however, you should!

Obviously, don’t smoke (even smoking outside and then coming into the house contaminates the air – just quit already).Try to open windows and create cross ventilation whenever possible. Avoid air fresheners and candles.

Here are two links (here and here) to learn more about indoor air pollutants.

Nutrition

What a child eats absolutely contributes to over health and in some research has been seen to affect the clinical manifestation and development of autism.[*]

We even know that certain nutritional interventions can even reverse underlying biochemical disturbances seen in autism (improvements in behavioral characteristics such as repetitive stereotypes, hyperactivity, social contact, and self-injurious behavior).[*][*]

Eliminate HFCS

Autism prevalence is related to the consumption of high fructose corn syrup (HFCS) for a variety of reasons. It seems that the ingestion of HFCS leads to mineral imbalances which create multiple pathways for oxidative stress in the brain from exposure to OP pesticides and heavy metals.[*]

HFCS is found in sodas, junk foods, and processed snacks…adds one more reason not to buy that crap.

Avoid artificial food dyes and colorings

Autism has also been associated with certain artificial coloring additives found in processed foods. They also interfere with neurological processes (particularly behavior, personality and learning ability).[*][*][*]

Eat more Omega-3s

Evidence is mounting that a deficiency in omega-3 fatty acids can contribute to childhood neurodevelopmental disorders.[*]

Omega-3 supplementation for treatment of children with ASD has been found to improve cognition, sleep, social interaction, eye contact and sleep.[*][*][*][*]

Omega-3 fatty acids also promote growth of neurons within the brain and can strengthen the surrounding myelin sheaths.

An excellent source of omega-3s is wild caught salmon, flax seeds, walnuts and some dark, leafy green vegetables. Krill oil is also a popular option (which can be a mercury-free source of fish oil) –supplements like Nordic Natural or OmegaBrite are great supplement options.[*]

Take Vitamin D3 supplements

Vitamin D plays a critical role in the development of the brain and research shows it is essential for normal brain functioning. Literature suggests that maternal vitamin D3 deficiency increases risk for autism in children.[*][*][*]

The numbers I’ve seen - If you are pregnant, it is suggested to take 5,000 IUs daily. If you are nursing, take 7,000 IUs daily.[*]

I currently give my daughters 1,200 IUs daily along with a multivitamin. (Be mindful of HFCS and artificial coloring-read the label of your vitamins, especially those made for children.)

Avoid Antibiotics

(and if you can’t, avoid repeated/long-term use and always employ use of probiotics)

Using antibiotics eliminate both harmful and beneficial bacteria in the gastrointestinal tract. Over 500 hundred different kinds of beneficial bacteria is located in the small and large intestines of which hundreds of functions are performed for health metabolism and immune function. Through certain enzyme secretions, these healthy bacteria transform metabolic and microbial wastes (which include hormones, chemical waste, bile, viral toxins, bacterial toxins, cellular debris, etc.).[*]

Research has emphasized caution regarding the increase in use of antibiotic course treatments in children and its association with ASD (particularly the damage done to the intestines).[*][*][*][*][*][*]

Children that are breastfed, and who are breastfed for longer periods have a lower risk of being diagnosed with autism. As this is the case, it is also very important for the nursing mother to be aware of her exposure to environmental toxicity and nutritional deficiencies.[*][*][*][*][*]

If you find yourself unable to breastfeed, then be sure to find a formula that does (1) not contain HFCS (2) is organic (3) is supplemented with DHA/ARA. And when preparing formula try your best to use (1) unfluorinate bottled/filtered water and (2) glass or stainless steel bottles.

Limit dairy

In particular casein which is in all milk products. Casein has been documented in aggravating clinical symptoms of autism. Casein in dairy products breaks down into a peptide fragment called casomorphin which has opioid characteristics (yes, you’re literally addicted to cheese).[*][*]

If you are unsure reducing dairy is a good direction for your family, consider that many children (and adults) suffer from dairy intolerance which is much more difficult to diagnose then dairy allergy. Some symptoms of dairy intolerance are eczema and diarrhea (foul smelling poo). Some related dairy problems are ear infections, asthma, hives, ADD/ADHD and autism

Limiting milk/dairy does not mean giving up calcium. Many foods (such as cereals and rice) are enriched with calcium – not to mention that green veggies like spinach and broccoli are awesome sources of calcium as well.

Although mainstream media, certain vaccine inventors (Paul Offit) and the majority of pediatricians would like to eradicate all vaccine-autism discussions, there are many scientists supporting research that remains to be completed regarding vaccine safety and autism.

In 2009, the director of one NIH (National Institute of Health) agency stated there is legitimate concern and a valid call to study a group of the pediatric population more susceptible (on a genetic basis) to develop ASD in response to vaccination.[*]

There is a lack of clear evidence to either refute or accept a specific relationship, but concern exists regarding cross-reacting response to particular vaccine component, a mitochondrial disorder, or other yet-unknown responses that a subpopulation of children may be susceptible to.

Some other recent research states:

There is very current research now questioning the use of aluminum in vaccines and its ability to cause ASD. 2008[*]

Further study into the relationship between vaccines and autism is warranted. 2011 [*]

Experimental research clearly shows that aluminum adjuvants have a potential to induce serious immunological disorders in humans. In particular, aluminum in adjuvant form carries a risk for autoimmunity, long-term brain inflammation and associated neurological complications and may thus have profound and widespread adverse health consequences. 2011 [*]

What is becoming more evident in autism research is the link between the immune and neurological systems and the concern that a dysregulated or abnormal immune response may be involved in some forms of ASD.[*]

Hyperactivity in immune cells and molecules, such as cytokines, can affect cognitive and emotional processing particularly in the modulation of systemic and CNS responses to infection, injury, and inflammation.[*]

This absolutely does not mean rejecting vaccines.

What this does mean is making informative decisions about your child’s vaccination schedule.

Wait if your child is sick

Postpone vaccination 1 or 2 weeks until your child is healthy (or if he/she was recently on antibiotics).

No Tylenol (Acetaminophen)

Never use Tylenol before or after vaccination.

According to one study completed in 2008, acetaminophen use after vaccination was significantly associated with autistic disorder with children 5 years of age or younger.[*]

This significant association is believed to be due to acetaminophen reducing the available amount of glutathione in the body – which is needed to eliminate toxins.

Delay and/or Select

The most effective and cautious course to pediatric health care is an individual approach.

Vaccination is not all or nothing. For example, your newborn might not need the Hepatitis B vaccine – a better choice may be to delay. That is your choice.

The current ACIP and CDC recommended vaccine schedule is not based on research testing the schedule in its entirety. [*Pg83]

In fact, the most recent report (2013, by IOM) stated, “No evidence is available from studies that have directly examined the current immunization schedule (most studies enrolled children in the 1990s, and most were not conducted in the United States)”.[*]

The first step in making responsible choices in your child’s vaccination schedule is to learn about the disease (prevalence, diagnosis, treatment, etc) you are going to vaccinate against. An excellent resource is NVIC – which has a user friendly site listing information on each disease and the corresponding licensed vaccines. Another resource to confirm the data found on NVIC is the CDC’s Pinkbook.

Many of these lifestyle and dietary adjustments not only are associated with a decrease in ASD, but they offer a myriad of overall health benefits.

Do your best to provide superior sources of nutrition for your children, be mindful of their environment and utilize an individualized vaccine schedule.

Each child depends, in a very large part, on their caregiver to help them be healthy to explore, dream and create their lives. If there is chance that chemicals are going to interfere with such wonderment then we must be diligent in using them in a sensible and responsible manner-whether that be agricultural pesticides, cleaners used in our schools, chemical additives to food, or in our method of reducing communicable disease.

This post was inspired after watching the Fall 2012 ARI Conference presentation of ’10 Americans’ by President and Co-founder of the Environmental Working Group (EWG) Ken Cook.

Ken reveals the shocking number of toxic chemicals EWG's research team found in the umbilical cord blood of 10 American babies born in 2004. This landmark study affirms the negative impact that environmental pollution can have on human health, especially relating to autoimmune diseases and autism.

Before becoming vegan myself, there was an idea already in my head of some airy-fairy, mid-twenty new-ager who spoke of horror stories of undercover footage of how factory farm animals were treated or, better yet, someone throwing buckets of blood on people who bought fur coats…all in hopes of converting the uneducated meat-eating masses.

At the beginning, I did NOT decide to stop eating meat/dairy because of the humane aspect. In fact, my main reason was for the health benefits (check out The China Study to begin learning more). Although, I was (at least I thought I was) aware of the humane characteristic of the lifestyle –I never planned on shunning a Coach purse made of leather or bother finding out if the cosmetics I was buying was tested on animals or not.

Sure, I felt that the ethics a ‘lifestyle-vegan’ stood for was great and all, but I never thought of ever actually choosing to become one.

That’s the thing – no one everthinks they are going to become vegan. You simply do notchoosechange like that.

About 8 months into my journey in eliminating meat and dairy, I found I had enough courage to begin to bear witness with my eyes and my ears to what we make approximately 72 billion animals (each year) bear witness to with their bodies and souls.

I purchased Peaceable Kingdom: The Journey Home and it was incredibly honest and incredibly powerful. (If you are wondering, this is NOT one of those documentaries that goes undercover and tries to shock-change people, you can learn more about it here)

Visual images are very powerful to humans. It’s very challenging to grab a rubber erase or a bottle of white out and simply scrap the emotion and reactions felt when witnessing a particularly moving visual scene. I think we all can easily re-call the smoke billowing out from the twin towers from 9/11 or those graphic pictures we where shown in high school history books of bodies piled up during the Holocaust.

People use many reasons to avoid addressing particular humane issues when it comes to the food they eat. People simply have “enough on their plate” as it is and challenging the deepest aspects of a person’s upbringing and education is enormously daunting. Not to mention that we are all pretty much neatly removed from observing any horrors of the meat, dairy and egg industry – just look at all those happy cow commercials, right?

Meat-eating, dairy-loving people truly believe themselves to be kind and compassionate to animals; they love their dog and cats, they give money to the local animal shelter and they even brake for a family of Canadian geese crossing a semi-busy street.

What is the underlying catalyst among those animal-friendly people who become vegan and those who do not?

I’m not sure if it’s because I’m a mother now (there are a tremendous amount of changes I’ve made since being a parent and I’m not sure if this can be attributed to motherhood or not), but the images and knowledge I now have pertaining to the unethical treatment (particularly of dairy cows - and their calves) has damaged me and when I recall the information I feel as sick as I did when I first learn of it.

In a strange turn of events, the one thing I thought I would never be able cease (dairy) is one of the main factors that has solidified me becoming vegan.

Dairy. is. no. longer. appetizing. to. me.

(…not to mention there are great alternatives available).

True, dairy cows aren’t raised solely for the purpose for slaughter…instead, to put it in perspective, their devastating existence is drawn out a few years longer. One dairy cow will give birth to approximately 3-6 calves all whom are immediately taken from her. The female cow will be administered hormones and a constant stream of antibiotics. The substantially unnatural demand of lactation will deplete calcium from her own bones – the bottom-line: that she will generate enough milk to fill as many half-pint containers for school children to drink each day as possible.

When she finally finds herself free from this “life”, her body will produce 2,000 quarter-pounders to a fast food franchise that will serve 7 billion low-cost happy-meals a year.

****

I was asked last week by a colleague at work, if I truly believe the future of our diet as a community will not consist of consuming meat and/or dairy products.

I took a minute to consider the question and answer him honestly. The answer that surfaced did not surprised me, however the rationale did.

The answer is no, simply because compassion and reverence for Life is the goal of our human evolution.

Embracing veganism is not a moderate resolution. Instead, it is a dramatic, courageous, positive change the world is destined to experience.

It takes courage to witness the suffering and cruelty that is being done on our watch. A part of you breaks. From that space, reverence and authenticity emerges.

The feedback I got when I asked my friends how they viewed people who choose not to eat meat/dairy was indifferent.

‘It’s everyone’s choice to eat what they want.’

‘As long as ‘they’ aren’t pushing their beliefs on me, then it’s fine.’

However, one simply does not choose to become vegan so it is impossible to try and ‘convert’ someone.

Becoming vegan is definitely isolating at times and (as with anything challenging within ourselves) it’s easy and more comfortable to focus on judging others – but that’s not what I choose to do. I hope the people around me don’t think I am judging them or hoping to ‘convert’ them – because I truly understand veganism not to be a choice.

You see, I recognize that the only way to eliminate pain and suffering (by both animal and human) is very simple. Create Love and compassion in this world. This is our contribution and gift back to God (or whatever you choose to call it – the Source, the Divine, Buddha, etc). This Gift is not just a vegan’s gift but every and every one of us - to every creature (human and non-human) and with this we have the power to evolve our human race.

Being a full-time, working mother and blogger is incredibly rewarding… and challenging.

I know as this blog gains exposure so goes hand-in-hand an increase in (sometime abrasive) criticism and more glaring disapproval.

I’m definitely not the toughest blogger on the block and I imagine I’m not alone in this respect (behind the screen is always a person with feelings and real-life situations). Sure, sometimes I’ll get anxious before publishing certain posts or I’ll struggle with how to word certain sensitive topics so I do not offend anyone (if that is even obtainable)…

To be honest, the initial goal of this blog was to share information and research I (as a new mom and wife) came across online. From there, posts have evolved to include development of spirituality, marriage, and relationships. I do my best to provide resources (when applicable) and one of my most important goals is to become a touch-stone for like-minded mothers out there – to let them know they are part of a growing community and they are not alone.

I think one simple way to clear things up is a declaration of sorts….so this might get a bit personal.

This post is one holistic (natural, crunchy, alternative, progressive, or whichever label you prefer to use) blogging mom’s declaration of intent on behalf of her natural parenting community.

Natural Mom Manifesto

As parents, we hold a responsibility in becoming aware and knowledgeable of not only conventional options but also of alternative ones (especially within pivotal issues such as health, childbirth, nutrition, discipline, etc) in order to make a well-informed choice that will best suit the needs of our family and is in line with our personal values.

People evolve and learn at different rates and degrees over time. It is imperative we show respect to other human beings no matter their choice, circumstances or actions.

We understand that teaching our children the reverence, respect and value for life is best accomplished by modeling our own behavior and is developed overtime within our parenting choices, interpersonal-relationships, and lifestyle preferences.

When certain progressive parenting styles are mentioned (such as natural birth, normal-term breastfeeding, or genital integrity) it is done because we sincerely deem these practices as beneficial (in the majority of cases) and scientifically sound. It is on no account ever to be considered ridiculing or deriding someone’s personal circumstances.

We take an active, daily approach in health and healing processes (physically and emotionally) that appreciates minimally invasive healthcare options while respecting the unique benefits of utilizing conventional care if/when necessary. Health is examined through a holistic lens and is understood that every aspect of our lives influences the outcome.

The cornerstone of life (and parenting) is to receive each day as an opportunity to learn and love more then the day before.

Acknowledgement of the vulnerability that comes with parenting is important. We understand that all parents are susceptible to emotional pain/hurt feelings even when the intention may not be coming from a critical source. Demonstration of compassion and kindness should never be devalued (even in cases where it is not being reciprocated).

The path of progressive parenting within a conventional community is not something a person elects spontaneously—rather, it is a way of life that persists and develops over time.

This manifesto is dedicated to each and every individual that has allowed my Light to shine brighter along this adventurous path we call parenthood.

Next weekend, there will be peaceful demonstrations and marches across the country to raise awareness of this issue.

Take Action NOW

Circumcision is perpetuated by silence.

If you are wondering what YOU can do, right now, to help end male genital mutilation see below:

(clickable links will take you directly to an easy search for your representative and their email contact)

(1) Write your local House (find your rep by entering your zip code in the top right hand corner of website) and Senate congressional members along with President Obama and ask them to sponsor the MGM Bill proposal. (Below is an example of what you can write in your email contact – simply copy and paste!)

I am writing to ask you to sponsor a proposed bill that would protect boys from the harmful practice of male genital mutilation, also known as circumcision. As you may already know, circumcision removes the most sexually sensitive parts of a boy’s penis, including the foreskin, the frenulum, and the ridged band of nerves. Although girls have been legally protected from all forms of genital cutting since 1997, nearly 60% of boys in the U.S. are still circumcised without their consent because no specific federal law exists to protect them.

No national medical association in the world recommends that boys be forcefully circumcised for preventive health reasons. In addition, the Fourteenth Amendment to our U.S. Constitution guarantees every citizen equal protection of the laws. If we care enough to protect our girls from circumcision, shouldn’t we care enough to protect our boys as well?

The proposed legislation that would end this discrimination is called the MGM Bill. It was submitted to every member of Congress and 9 state legislatures on January 14, 2013, and I have enclosed a copy with this letter in case you have not yet seen it. You can also learn more about the harmful effects of circumcision on the group’s website, at www.mgmbill.org.

For the sake of men’s sexual health, human rights, and citizen equality, I urge you to take a stand against male genital mutilation. Please sponsor the MGM Bill!

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, to amend the Female Genital Mutilation Act of 1996 (a) so that boys, intersex individuals, and nonconsenting adults may also be protected from genital mutilation; (b) to increase the maximum punishment of offense to 14 years imprisonment, (c) to include assistance or facilitation of genital mutilation of children or nonconsenting adults as an offense, and (d) to prohibit persons in the U.S. from arranging or facilitating genital mutilation of children and nonconsenting adults in foreign countries.

SECTION 1. SHORT TITLE

This Act may be cited as the "Federal Prohibition of Genital Mutilation Act of 2013".

SECTION 2. TITLE 18 AMENDMENT

(A) IN GENERAL.--Title 18, Part I, Chapter 7, Section 116 of the United States Code is amended by revising the text to read as follows:

"116. GENITAL MUTILATION

"(a) Except as provided in subsection (b), whoever knowingly circumcises, excises, cuts, or mutilates the whole or any part of the labia majora, labia minora, clitoris, vulva, breasts, nipples, foreskin, glans, testicles, penis, ambiguous genitalia, hermaphroditic genitalia, or genital organs of another person who has not attained the age of 18 years or on any nonconsenting adult; whoever prematurely and forcibly retracts the penile or clitoral prepuce of another person who has not attained the age of 18 years or on any nonconsenting adult, except to the extent that the prepuce has already separated from the glans; whoever knowingly assists with or facilitates any of these acts; or whoever arranges, plans, aids, abets, counsels, facilitates, or procures a genital mutilation operation on another person outside the United States who has not attained the age of 18 years or on any nonconsenting adult outside the United States shall be fined under this title or imprisoned not more than 14 years, or both.

"(b) A surgical operation is not a violation of this section if the operation is (1) performed on a person who has not attained the age of 18 years and is necessary to the physical health of the person on whom it is performed because of a clear, compelling, and immediate medical need with no less-destructive alternative treatment available, and is performed by a person licensed in the place of its performance as a medical practitioner; (2) performed on an adult who is physically unable to give consent and there is a clear, compelling, and immediate medical need with no less-destructive alternative treatment available, and is performed by a person licensed in the place of its performance as a medical practitioner; or (3) performed on a person in labor or who has just given birth and is performed for medical purposes connected with that labor or birth because of a clear, compelling, and immediate medical need with no less-destructive alternative treatment available, and is performed by a person licensed in the place it is performed as a medical practitioner, midwife, or person in training to become such a practitioner or midwife.

"(c) In applying subsection (b), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that or any other person that the operation is required as a matter of custom or ritual.

(B) CLERICAL AMENDMENT.--The table of sections at the beginning of Chapter 7 of Title 18, Part I, of the United States Code, is amended by revising Section 116 to read "116. Genital mutilation."

SECTION 3. INFORMATION AND EDUCATION REGARDING GENITAL MUTILATION

(A) IN GENERAL. -- The Secretary of Health and Human Services shall carry out the following activities:

(1) Compile data on the number of persons of all sexes living in the United States who have been subjected to genital mutilation (whether in the United States or in their countries of origin), including a specification of the number of children under the age of 18 who have been subjected to such mutilation.

(2) Identify communities in the United States that practice genital mutilation, and design and carry out outreach activities to educate individuals in the communities on the physical and psychological effects of such practice. Such outreach activities shall be designed and implemented in collaboration with representatives of the ethnic groups practicing such mutilation and with representatives of organizations with expertise in preventing such practice.

(3) Develop recommendations for the education of students of schools of medicine and osteopathic medicine regarding genital mutilation and complications arising from such mutilation, as well as complications arising from premature forcible retraction of the prepuce. Such recommendations shall be disseminated to such schools.

(B) IN GENERAL. -- The President shall carry out the following activities:

(1) Seek to end the practice of genital mutilation worldwide through the active cooperation and participation of governments in countries where genital mutilation takes place.

(b) assisting nations in creating culturally appropriate outreach programs that include education and counseling about the dangers of genital mutilation to people of all ages; and

(c) ensuring that all appropriate programs in which the United States participates include a component pertaining to genital mutilation, so as to ensure consistency across the spectrum of health and child related programs conducted in any country in which genital mutilation is known to be a problem.

(C) DEFINITIONS. -- For purpose of this Act, the term "genital mutilation" means the removal or cutting (or both) of the whole or part of the clitoris, labia minora, labia majora, vulva, breasts, nipples, foreskin, glans, testicles, penis, ambiguous genitalia, hermaphroditic genitalia, or genital organs. The term "premature forcible retraction of the penile or clitoral prepuce" means forced retraction of the prepuce from the glans, except to the extent that the prepuce has already separated from the glans. The term "prepuce" means foreskin. The term "adult" means a person who has attained the age of 18 years. The term "nonconsenting" means not wishing to undergo genital mutilation.

SECTION 4. EFFECTIVE DATES

Section 2 of this Act shall take effect immediately after the date of the enactment of this Act. Section 3 of this Act shall take effect immediately after the date of the enactment of this Act, and the Secretary of Health and Human Services and the President shall commence carrying it out not later than 90 days after the date of the enactment of this Act.